Local 1199 of the Service Employees International Union is leading a major effort to unionize nearly 190,000 personal caregivers working across New York, marking one of the largest labor campaigns in recent U.S. history. These caregivers, often employed individually in private homes rather than institutional settings, provide essential support to elderly, disabled, and chronically ill New Yorkers.
As of this week, the union has collected union authorization cards from approximately 70,000 personal assistants—an important milestone toward holding a labor election. On Tuesday, Local 1199 submitted a petition to the National Labor Relations Board requesting an election so these workers can decide whether to join the union.
Personal assistants in New York City earn at least $20.65 per hour, with base wages elsewhere in the state ranging from $18.65 to $20.05. Their compensation is funded through New York’s Medicaid program, which draws from both state and federal resources. Yvonne Armstrong, president of Local 1199, highlighted the economic pressures facing many caregivers, noting rising costs for necessities such as groceries, rent, and healthcare while wages have stagnated.
The caregiving program, known as the Consumer Directed Personal Assistance Program, allows vulnerable individuals to hire family members, friends, or neighbors to provide daily support, including help with personal hygiene, meal preparation, and mobility. Over three decades, the program has expanded from serving around 12,000 clients statewide to more than 200,000, at an estimated annual cost of $11 billion.
This rapid growth has ignited debates about the program’s integrity. Governor Kathy Hochul described it in recent remarks as “one of the most abused programs in the entire history of the state of New York,” citing investigations into fraudulent “no-show” jobs that have sometimes persisted for years. Public Partnerships, a single company contracted by the state to manage the program’s administration, acknowledged the right of personal assistants to determine their stance on unionization but declined further comment on the issue.
The transition to Public Partnerships was intended to simplify oversight and reduce fraud; previously, more than 700 agencies acted as intermediaries managing enrollment and payments. While state officials assert this change has saved over $1 billion and eliminated unnecessary administrative costs, the U.S. Justice Department has sued New York, alleging that the contract was awarded through a flawed selection process and that Public Partnerships misrepresented its capabilities—a claim denied by the company.
For many caregivers and clients, the program is a vital resource. Andrea Rodriguez of Buffalo, paralyzed by multiple sclerosis, relies on several caregivers, including childhood friend and former union steelworker Ingeri Eaton. Eaton, who helps with medication, personal care, and daily tasks, supports the union drive but acknowledged that some caregivers remain uncertain about what union membership entails. She expressed hope that unionization would reduce the isolation intrinsic to working alone and foster community among caregivers.
Should the union succeed, Local 1199’s membership would increase by about 40%, becoming a significant political force in New York. Any collective bargaining agreements would be negotiated directly with Public Partnerships. However, higher wages could potentially raise costs borne by the state Medicaid program.
The New York State Department of Health said it respects workers’ rights to representation but has not taken a formal position on the unionization effort. The outcome of the NLRB election will shape the future landscape for thousands of caregivers providing critical, in-home health services.